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The document provides information on caring for and maintaining a Schiotz tonometer, which is a simple and durable instrument used to measure intraocular pressure. It consists of a hollow barrel with a plunger attached to weights. When placed on the eye, the plunger indents the cornea and a scale reading correlates to estimated pressure. It requires little maintenance but should be calibrated daily and cleaned once per day to prevent sticking. Understanding how to use and care for the Schiotz tonometer properly is important for remote clinics relying on this affordable instrument.
The document provides information on caring for and maintaining a Schiotz tonometer, which is a simple and durable instrument used to measure intraocular pressure. It consists of a hollow barrel with a plunger attached to weights. When placed on the eye, the plunger indents the cornea and a scale reading correlates to estimated pressure. It requires little maintenance but should be calibrated daily and cleaned once per day to prevent sticking. Understanding how to use and care for the Schiotz tonometer properly is important for remote clinics relying on this affordable instrument.
The document provides information on caring for and maintaining a Schiotz tonometer, which is a simple and durable instrument used to measure intraocular pressure. It consists of a hollow barrel with a plunger attached to weights. When placed on the eye, the plunger indents the cornea and a scale reading correlates to estimated pressure. It requires little maintenance but should be calibrated daily and cleaned once per day to prevent sticking. Understanding how to use and care for the Schiotz tonometer properly is important for remote clinics relying on this affordable instrument.
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Understanding and caring for
or thigh may be used (change the site used if frequent measurements are needed). • Use an alcohol swab to clean the site and let the alcohol dry. • Insert the test strip into the monitor, a Schiotz tonometer following the instructions (Figure 1). Ismael Cordero • Use a single-use lancet or a lancing Clinical Engineer, Philadelphia, USA. Figure 1 device to draw blood (Figure 2) and ismaelcordero@me.com dispose of it in a sharps container. • Apply the blood to the testing strip A Schiotz tonometer is an instrument for Scale (Figure 3) in the correct way: some measuring the intraocular pressure (IOP). strips need the blood drop to be over Although the Schiotz tonometer does the whole of the test pad and some not make as precise measurements as Needle suck up the blood directly from the site other types of tonometers, it is of the bleeding. inexpensive, simple to use, durable, • Place the alcohol swab (note: it will Weights requires little maintenance, does not sting) or a piece of gauze over the site have electronics, does not require (Figure 4) and hold it there, or let the batteries, and can be stored for years patient hold it there until the bleeding between uses. These qualities make it stops. Monitor for excess bleeding. well suited for screening and remote or • Read and record the result, reporting Lever arm mobile clinics. and/or responding to abnormal readings. The Schiotz tonometer consists of a Plunger • Tell the patient what the result is, hollow barrel with a concave footplate explain it and discuss options. Holder and a holder (Figure 1). A free-floating, • Dispose of all used equipment safely, rod-like plunger with a 5.5 gram weight Barrel in line with hospital or health care attached fits inside the barrel. When policies. held vertically on top of the eye, the plunger will move downwards by gravity Foot plate and indent the cornea. This very small Calibrating the blood up-and-down movement is magnified by Test block glucose monitor a lever arm to move a needle that gives Calibration check procedure a reading on a horizontal scale numbered A calibration check should be done at • Calibrate the monitor and each new arbitrarily 0–20. A firmer eye, due to the start of every day. Place the footplate pack of test strips together. higher IOP, will result in a lower inden- of the instrument on the rounded test • Calibrate the monitor each week. tation and a lower reading on the scale. block (the dummy cornea) provided with • Place the control solution on a test Since the Schiotz tonometer does the tonometer’s storage case. With the strip and check that the value not measure pressure directly, a footplate resting on the test block, a shown on the monitor matches the conversion table, supplied with the correctly calibrated instrument will have value on the bottle (or the pack of instrument, is used to translate scale a scale reading of zero. strips it accompanies). Record the readings into estimates of IOP in mmHg. If not, you can calibrate it to zero. calibration readings. To account for the range of pressure, • If the needle is to the left of zero, • If one is provided, use the check other weights (typically 7.5 g and 10 g) rotate the footplate in a clockwise strip to make sure that the meter is are supplied that can be added to the direction and check again. working. plunger. • If the needle is to the right of the zero Table 1. Schiotz scale conversion table position, rotate the footplate in an anti-clockwise direction. Figure 4 Scale Ocular pressure, reading mmHg Cleaning Cleaning of the barrel and the plunger 5.5 g 7.5 g 10.0 g should be done once a day to prevent weight weight weight the plunger from sticking to the barrel. 3.0 24.4 35.8 50.6 1 Remove the plunger and use gauze with 4.0 20.6 30.4 43.4 alcohol to clean the plunger and tip. 2 Clean the inside of the barrel with an 5.0 17.3 25.8 37.2 alcohol-soaked cotton swab and then with a dry cotton swab. 6.0 14.6 21.9 31.8 3 Clean the footplate with gauze and 7.0 12.2 18.5 27.2 alcohol. Elmien Wolvaardt Ellison
4 Allow it to dry and then place, disas-
8.0 10.2 15.6 23.1 sembled, in its case. 9.0 8.5 13.1 19.6 In between patients, the Schiotz tonometer should be disinfected by 10.0 7.1 10.9 16.5 soaking it in sodium hypochlorite.
COMMUNITY EYE HEALTH JOURNAL | VOLUME 26 87 | 2013